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ECON 472 : Economics Of Health Care
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ECON 472 : Economics Of Health Care
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Course Code: ECON 472
University: University Of Southern California
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Country: United States
Question:
Part 1. Identify if our health care system uses reference pricing and identify how it would benefit consumers and payers of health care services benefit. Visit my “Healthcare Economics Collection”.
Part 2. What are the economic goals CMS is attempting to achieve through The Centers for Medicare and Medicaid Services Innovation and why?
Answer:
Part ONE: Reference pricing
The term reference pricing is largely used in the healthcare industry to mean that the sponsors of a certain care plan pay a fixed amount of cash, or even limiting their contributions, for the plan that is offered to the care receivers. In return, the plan members may be subjected to paying the remaining amount costs if the care service is expensive than the already paid fees. Basically, it is a form of predetermined contributions health benefits (Denoyel, Alfandari, & Thiele, 2017).
The CMS and reference pricing
The Center for Medicare & Medicaid Services (CMS) broadly utilizes the aspects of reference pricing whereby different stakeholders are involved in certain care programs. Their ideas are, also, put into consideration as to whether provide better healthcare at a higher price, reduce the cost of the care to match the plans, and/or better payment channels for the patients. The patients then pay for the remaining little cost especially those that are beneficiaries of Medicaid, Medicare, and the Children’s Health Insurance Program (CHIP).
Part TWO: The economic goals
Currently, the CMS is focused on several economic goals that include the effective testing of the service delivery and payment models, engaging stakeholders from different parts of our country, and analyzing the results attained and promoting best practices in care provision.
The reason behind the focus of the above economic goals is to ensure that new means of payment is available to the care receivers in a manner that is clear and open from any malicious actions such as fraud. In addition, these goals aim at providing each stakeholder a chance to express their opinions of how best the care services can be delivered to the receivers at lower costs while still consulting the clinical experts (Center for Medicare & Medicaid Services, 2018).
References:
Center for Medicare & Medicaid Services. (2018, May 05). About the CMS Innovation Center. Retrieved July 2018, from Center for Medicare & Medicaid Services: https://innovation.cms.gov/About/index.html
Denoyel, V., Alfandari, L., & Thiele, A. (2017). Optimizing healthcare network design under Reference Pricing and parameter uncertainty. European Journal of Operational Research, 263(3), 996-1006.
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My Assignment Help. (2020). Economics Of Health Care. Retrieved from https://myassignmenthelp.com/free-samples/econ-472-economics-of-health-care/medicare-medicaid-services.html.
“Economics Of Health Care.” My Assignment Help, 2020, https://myassignmenthelp.com/free-samples/econ-472-economics-of-health-care/medicare-medicaid-services.html.
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My Assignment Help. Economics Of Health Care [Internet]. My Assignment Help. 2020 [cited 18 December 2021]. Available from: https://myassignmenthelp.com/free-samples/econ-472-economics-of-health-care/medicare-medicaid-services.html.
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